Bronson Battle Creek

All Charges

Charge

Type

Setting

Price

HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER

Facility

$10,241.99

Service Code	CPT 36247
Hospital Charge Code	36100112
Hospital Revenue Code	361
Min. Negotiated Rate	$6,452.45
Max. Negotiated Rate	$9,217.79
Rate for Payer: Aetna Commercial	$8,705.69
Rate for Payer: Aetna New Business (MI Preferred)	$6,657.29
Rate for Payer: Cash Price	$8,193.59
Rate for Payer: Cofinity Commercial	$7,169.39
Rate for Payer: Cofinity Commercial	$8,808.11
Rate for Payer: Healthscope Commercial	$9,217.79
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$8,705.69
Rate for Payer: PHP Commercial	$8,705.69
Rate for Payer: Priority Health Cigna Priority Health	$7,169.39
Rate for Payer: Priority Health SBD	$6,452.45

HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER

Facility

$10,241.99

Service Code	CPT 36247
Hospital Charge Code	36100112
Hospital Revenue Code	361
Min. Negotiated Rate	$284.55
Max. Negotiated Rate	$9,217.79
Rate for Payer: Aetna Commercial	$8,705.69
Rate for Payer: Aetna New Business (MI Preferred)	$6,657.29
Rate for Payer: BCBS Complete	$4,096.80
Rate for Payer: BCBS Trust/PPO	$2,565.06
Rate for Payer: Cash Price	$8,193.59
Rate for Payer: Cash Price	$8,193.59
Rate for Payer: Cofinity Commercial	$8,808.11
Rate for Payer: Cofinity Commercial	$7,169.39
Rate for Payer: Healthscope Commercial	$9,217.79
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$8,705.69
Rate for Payer: PHP Commercial	$8,705.69
Rate for Payer: Priority Health Cigna Priority Health	$7,169.39
Rate for Payer: Priority Health SBD	$6,452.45
Rate for Payer: UHC All Payor (Choice/PPO)	$313.00
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$284.55

HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER

Facility

$1,000.76

Service Code	CPT 36248
Hospital Charge Code	36100113
Hospital Revenue Code	361
Min. Negotiated Rate	$630.48
Max. Negotiated Rate	$900.68
Rate for Payer: Aetna Commercial	$850.65
Rate for Payer: Aetna New Business (MI Preferred)	$650.49
Rate for Payer: Cash Price	$800.61
Rate for Payer: Cofinity Commercial	$700.53
Rate for Payer: Cofinity Commercial	$860.65
Rate for Payer: Healthscope Commercial	$900.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$850.65
Rate for Payer: PHP Commercial	$850.65
Rate for Payer: Priority Health Cigna Priority Health	$700.53
Rate for Payer: Priority Health SBD	$630.48

HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER

Facility

$1,000.76

Service Code	CPT 36248
Hospital Charge Code	36100113
Hospital Revenue Code	361
Min. Negotiated Rate	$45.84
Max. Negotiated Rate	$900.68
Rate for Payer: Aetna Commercial	$850.65
Rate for Payer: Aetna New Business (MI Preferred)	$650.49
Rate for Payer: BCBS Complete	$400.30
Rate for Payer: BCBS Trust/PPO	$304.91
Rate for Payer: Cash Price	$800.61
Rate for Payer: Cash Price	$800.61
Rate for Payer: Cofinity Commercial	$700.53
Rate for Payer: Cofinity Commercial	$860.65
Rate for Payer: Healthscope Commercial	$900.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$850.65
Rate for Payer: PHP Commercial	$850.65
Rate for Payer: Priority Health Cigna Priority Health	$700.53
Rate for Payer: Priority Health SBD	$630.48
Rate for Payer: UHC All Payor (Choice/PPO)	$50.42
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$45.84

HC PLACEMENT SELECTIVE PULMONARY

Facility

$912.16

Service Code	CPT 36014
Hospital Charge Code	36100100
Hospital Revenue Code	361
Min. Negotiated Rate	$144.40
Max. Negotiated Rate	$1,592.84
Rate for Payer: Aetna Commercial	$775.34
Rate for Payer: Aetna New Business (MI Preferred)	$592.90
Rate for Payer: BCBS Complete	$364.86
Rate for Payer: BCBS Trust/PPO	$1,592.84
Rate for Payer: Cash Price	$729.73
Rate for Payer: Cash Price	$729.73
Rate for Payer: Cofinity Commercial	$638.51
Rate for Payer: Cofinity Commercial	$784.46
Rate for Payer: Healthscope Commercial	$820.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$775.34
Rate for Payer: PHP Commercial	$775.34
Rate for Payer: Priority Health Cigna Priority Health	$638.51
Rate for Payer: Priority Health SBD	$574.66
Rate for Payer: UHC All Payor (Choice/PPO)	$158.84
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$144.40

HC PLACEMENT SELECTIVE PULMONARY

Facility

$912.16

Service Code	CPT 36014
Hospital Charge Code	36100100
Hospital Revenue Code	361
Min. Negotiated Rate	$574.66
Max. Negotiated Rate	$820.94
Rate for Payer: Aetna Commercial	$775.34
Rate for Payer: Aetna New Business (MI Preferred)	$592.90
Rate for Payer: Cash Price	$729.73
Rate for Payer: Cofinity Commercial	$638.51
Rate for Payer: Cofinity Commercial	$784.46
Rate for Payer: Healthscope Commercial	$820.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$775.34
Rate for Payer: PHP Commercial	$775.34
Rate for Payer: Priority Health Cigna Priority Health	$638.51
Rate for Payer: Priority Health SBD	$574.66

HC PLACEMENT SELECTIVE VENOUS 1ST ORDER

Facility

$5,773.44

Service Code	CPT 36011
Hospital Charge Code	36100097
Hospital Revenue Code	361
Min. Negotiated Rate	$148.99
Max. Negotiated Rate	$5,196.10
Rate for Payer: Aetna Commercial	$4,907.42
Rate for Payer: Aetna New Business (MI Preferred)	$3,752.74
Rate for Payer: BCBS Complete	$2,309.38
Rate for Payer: BCBS Trust/PPO	$2,014.24
Rate for Payer: Cash Price	$4,618.75
Rate for Payer: Cash Price	$4,618.75
Rate for Payer: Cofinity Commercial	$4,041.41
Rate for Payer: Cofinity Commercial	$4,965.16
Rate for Payer: Healthscope Commercial	$5,196.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,907.42
Rate for Payer: PHP Commercial	$4,907.42
Rate for Payer: Priority Health Cigna Priority Health	$4,041.41
Rate for Payer: Priority Health SBD	$3,637.27
Rate for Payer: UHC All Payor (Choice/PPO)	$163.89
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$148.99

HC PLACEMENT SELECTIVE VENOUS 1ST ORDER

Facility

$5,773.44

Service Code	CPT 36011
Hospital Charge Code	36100097
Hospital Revenue Code	361
Min. Negotiated Rate	$3,637.27
Max. Negotiated Rate	$5,196.10
Rate for Payer: Aetna Commercial	$4,907.42
Rate for Payer: Aetna New Business (MI Preferred)	$3,752.74
Rate for Payer: Cash Price	$4,618.75
Rate for Payer: Cofinity Commercial	$4,041.41
Rate for Payer: Cofinity Commercial	$4,965.16
Rate for Payer: Healthscope Commercial	$5,196.10
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,907.42
Rate for Payer: PHP Commercial	$4,907.42
Rate for Payer: Priority Health Cigna Priority Health	$4,041.41
Rate for Payer: Priority Health SBD	$3,637.27

HC PLACEMENT SELECTIVE VENOUS 2ND ORDER

Facility

$5,409.65

Service Code	CPT 36012
Hospital Charge Code	36100098
Hospital Revenue Code	361
Min. Negotiated Rate	$166.01
Max. Negotiated Rate	$4,868.68
Rate for Payer: Aetna Commercial	$4,598.20
Rate for Payer: Aetna New Business (MI Preferred)	$3,516.27
Rate for Payer: BCBS Complete	$2,163.86
Rate for Payer: BCBS Trust/PPO	$2,053.83
Rate for Payer: Cash Price	$4,327.72
Rate for Payer: Cash Price	$4,327.72
Rate for Payer: Cofinity Commercial	$4,652.30
Rate for Payer: Cofinity Commercial	$3,786.76
Rate for Payer: Healthscope Commercial	$4,868.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,598.20
Rate for Payer: PHP Commercial	$4,598.20
Rate for Payer: Priority Health Cigna Priority Health	$3,786.76
Rate for Payer: Priority Health SBD	$3,408.08
Rate for Payer: UHC All Payor (Choice/PPO)	$182.61
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$166.01

HC PLACEMENT SELECTIVE VENOUS 2ND ORDER

Facility

$5,409.65

Service Code	CPT 36012
Hospital Charge Code	36100098
Hospital Revenue Code	361
Min. Negotiated Rate	$3,408.08
Max. Negotiated Rate	$4,868.68
Rate for Payer: Aetna Commercial	$4,598.20
Rate for Payer: Aetna New Business (MI Preferred)	$3,516.27
Rate for Payer: Cash Price	$4,327.72
Rate for Payer: Cofinity Commercial	$3,786.76
Rate for Payer: Cofinity Commercial	$4,652.30
Rate for Payer: Healthscope Commercial	$4,868.68
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,598.20
Rate for Payer: PHP Commercial	$4,598.20
Rate for Payer: Priority Health Cigna Priority Health	$3,786.76
Rate for Payer: Priority Health SBD	$3,408.08

HC PLACE NEPHROSTOMY CATHETER

Facility

$3,282.56

Service Code	CPT 50432
Hospital Charge Code	36100504
Hospital Revenue Code	361
Min. Negotiated Rate	$2,068.01
Max. Negotiated Rate	$2,954.30
Rate for Payer: Aetna Commercial	$2,790.18
Rate for Payer: Aetna New Business (MI Preferred)	$2,133.66
Rate for Payer: Cash Price	$2,626.05
Rate for Payer: Cofinity Commercial	$2,297.79
Rate for Payer: Cofinity Commercial	$2,823.00
Rate for Payer: Healthscope Commercial	$2,954.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,790.18
Rate for Payer: PHP Commercial	$2,790.18
Rate for Payer: Priority Health Cigna Priority Health	$2,297.79
Rate for Payer: Priority Health SBD	$2,068.01

HC PLACE NEPHROSTOMY CATHETER

Facility

$3,282.56

Service Code	CPT 50432
Hospital Charge Code	36100504
Hospital Revenue Code	361
Min. Negotiated Rate	$195.16
Max. Negotiated Rate	$5,575.00
Rate for Payer: Aetna Commercial	$2,790.18
Rate for Payer: Aetna Medicare	$1,884.83
Rate for Payer: Aetna New Business (MI Preferred)	$2,133.66
Rate for Payer: Allen County Amish Medical Aid Commercial	$2,265.42
Rate for Payer: Amish Plain Church Group Commercial	$2,265.42
Rate for Payer: BCBS Complete	$1,041.01
Rate for Payer: BCBS MAPPO	$1,812.34
Rate for Payer: BCBS Trust/PPO	$2,254.13
Rate for Payer: BCN Medicare Advantage	$1,812.34
Rate for Payer: Cash Price	$2,626.05
Rate for Payer: Cash Price	$2,626.05
Rate for Payer: Cofinity Commercial	$2,823.00
Rate for Payer: Cofinity Commercial	$2,297.79
Rate for Payer: Health Alliance Plan Medicare Advantage	$1,812.34
Rate for Payer: Healthscope Commercial	$2,954.30
Rate for Payer: Mclaren Medicaid	$991.35
Rate for Payer: Mclaren Medicare	$1,812.34
Rate for Payer: Meridian Medicaid	$1,041.01
Rate for Payer: Meridian Wellcare - Medicare Advantage	$1,902.96
Rate for Payer: MI Amish Medical Board Commercial	$2,084.19
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,790.18
Rate for Payer: PACE Medicare	$1,721.72
Rate for Payer: PACE SWMI	$1,812.34
Rate for Payer: PHP Commercial	$2,790.18
Rate for Payer: PHP Medicare Advantage	$1,812.34
Rate for Payer: Priority Health Choice Medicaid	$991.35
Rate for Payer: Priority Health Cigna Priority Health	$2,297.79
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$5,575.00
Rate for Payer: Priority Health Medicare	$1,812.34
Rate for Payer: Priority Health Narrow Network	$4,460.00
Rate for Payer: Priority Health SBD	$2,068.01
Rate for Payer: Railroad Medicare Medicare	$1,812.34
Rate for Payer: UHC All Payor (Choice/PPO)	$214.68
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$1,812.34
Rate for Payer: UHC Exchange	$195.16
Rate for Payer: UHC Medicare Advantage	$1,866.71
Rate for Payer: VA VA	$1,812.34

HC PLACE NEPHROURETERAL CATHETER

Facility

$3,282.56

Service Code	CPT 50433
Hospital Charge Code	36100505
Hospital Revenue Code	361
Min. Negotiated Rate	$2,068.01
Max. Negotiated Rate	$2,954.30
Rate for Payer: Aetna Commercial	$2,790.18
Rate for Payer: Aetna New Business (MI Preferred)	$2,133.66
Rate for Payer: Cash Price	$2,626.05
Rate for Payer: Cofinity Commercial	$2,297.79
Rate for Payer: Cofinity Commercial	$2,823.00
Rate for Payer: Healthscope Commercial	$2,954.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,790.18
Rate for Payer: PHP Commercial	$2,790.18
Rate for Payer: Priority Health Cigna Priority Health	$2,297.79
Rate for Payer: Priority Health SBD	$2,068.01

HC PLACE NEPHROURETERAL CATHETER

Facility

$3,282.56

Service Code	CPT 50433
Hospital Charge Code	36100505
Hospital Revenue Code	361
Min. Negotiated Rate	$242.31
Max. Negotiated Rate	$9,573.02
Rate for Payer: Aetna Commercial	$2,790.18
Rate for Payer: Aetna Medicare	$3,226.04
Rate for Payer: Aetna New Business (MI Preferred)	$2,133.66
Rate for Payer: Allen County Amish Medical Aid Commercial	$3,877.45
Rate for Payer: Amish Plain Church Group Commercial	$3,877.45
Rate for Payer: BCBS Complete	$1,781.77
Rate for Payer: BCBS MAPPO	$3,101.96
Rate for Payer: BCBS Trust/PPO	$1,388.15
Rate for Payer: BCN Medicare Advantage	$3,101.96
Rate for Payer: Cash Price	$2,626.05
Rate for Payer: Cash Price	$2,626.05
Rate for Payer: Cofinity Commercial	$2,297.79
Rate for Payer: Cofinity Commercial	$2,823.00
Rate for Payer: Health Alliance Plan Medicare Advantage	$3,101.96
Rate for Payer: Healthscope Commercial	$2,954.30
Rate for Payer: Mclaren Medicaid	$1,696.77
Rate for Payer: Mclaren Medicare	$3,101.96
Rate for Payer: Meridian Medicaid	$1,781.77
Rate for Payer: Meridian Wellcare - Medicare Advantage	$3,257.06
Rate for Payer: MI Amish Medical Board Commercial	$3,567.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$2,790.18
Rate for Payer: PACE Medicare	$2,946.86
Rate for Payer: PACE SWMI	$3,101.96
Rate for Payer: PHP Commercial	$2,790.18
Rate for Payer: PHP Medicare Advantage	$3,101.96
Rate for Payer: Priority Health Choice Medicaid	$1,696.77
Rate for Payer: Priority Health Cigna Priority Health	$2,297.79
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$9,573.02
Rate for Payer: Priority Health Medicare	$3,101.96
Rate for Payer: Priority Health Narrow Network	$7,658.42
Rate for Payer: Priority Health SBD	$2,068.01
Rate for Payer: Railroad Medicare Medicare	$3,101.96
Rate for Payer: UHC All Payor (Choice/PPO)	$266.54
Rate for Payer: UHC Core	$4,155.00
Rate for Payer: UHC Dual Complete DSNP	$3,101.96
Rate for Payer: UHC Exchange	$242.31
Rate for Payer: UHC Medicare Advantage	$3,195.02
Rate for Payer: VA VA	$3,101.96

HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER

Facility

$8,255.44

Service Code	CPT 36245
Hospital Charge Code	36100474
Hospital Revenue Code	361
Min. Negotiated Rate	$225.28
Max. Negotiated Rate	$7,429.90
Rate for Payer: Aetna Commercial	$7,017.12
Rate for Payer: Aetna New Business (MI Preferred)	$5,366.04
Rate for Payer: BCBS Complete	$3,302.18
Rate for Payer: BCBS Trust/PPO	$2,598.40
Rate for Payer: Cash Price	$6,604.35
Rate for Payer: Cash Price	$6,604.35
Rate for Payer: Cofinity Commercial	$7,099.68
Rate for Payer: Cofinity Commercial	$5,778.81
Rate for Payer: Healthscope Commercial	$7,429.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7,017.12
Rate for Payer: PHP Commercial	$7,017.12
Rate for Payer: Priority Health Cigna Priority Health	$5,778.81
Rate for Payer: Priority Health SBD	$5,200.93
Rate for Payer: UHC All Payor (Choice/PPO)	$247.81
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$225.28

HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER

Facility

$8,255.44

Service Code	CPT 36245
Hospital Charge Code	36100474
Hospital Revenue Code	361
Min. Negotiated Rate	$5,200.93
Max. Negotiated Rate	$7,429.90
Rate for Payer: Aetna Commercial	$7,017.12
Rate for Payer: Aetna New Business (MI Preferred)	$5,366.04
Rate for Payer: Cash Price	$6,604.35
Rate for Payer: Cofinity Commercial	$7,099.68
Rate for Payer: Cofinity Commercial	$5,778.81
Rate for Payer: Healthscope Commercial	$7,429.90
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$7,017.12
Rate for Payer: PHP Commercial	$7,017.12
Rate for Payer: Priority Health Cigna Priority Health	$5,778.81
Rate for Payer: Priority Health SBD	$5,200.93

HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER

Facility

$5,277.07

Service Code	CPT 36246
Hospital Charge Code	36100475
Hospital Revenue Code	361
Min. Negotiated Rate	$241.65
Max. Negotiated Rate	$4,749.36
Rate for Payer: Aetna Commercial	$4,485.51
Rate for Payer: Aetna New Business (MI Preferred)	$3,430.10
Rate for Payer: BCBS Complete	$2,110.83
Rate for Payer: BCBS Trust/PPO	$1,934.34
Rate for Payer: Cash Price	$4,221.66
Rate for Payer: Cash Price	$4,221.66
Rate for Payer: Cofinity Commercial	$3,693.95
Rate for Payer: Cofinity Commercial	$4,538.28
Rate for Payer: Healthscope Commercial	$4,749.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,485.51
Rate for Payer: PHP Commercial	$4,485.51
Rate for Payer: Priority Health Cigna Priority Health	$3,693.95
Rate for Payer: Priority Health SBD	$3,324.55
Rate for Payer: UHC All Payor (Choice/PPO)	$265.82
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$241.65

HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER

Facility

$5,277.07

Service Code	CPT 36246
Hospital Charge Code	36100475
Hospital Revenue Code	361
Min. Negotiated Rate	$3,324.55
Max. Negotiated Rate	$4,749.36
Rate for Payer: Aetna Commercial	$4,485.51
Rate for Payer: Aetna New Business (MI Preferred)	$3,430.10
Rate for Payer: Cash Price	$4,221.66
Rate for Payer: Cofinity Commercial	$3,693.95
Rate for Payer: Cofinity Commercial	$4,538.28
Rate for Payer: Healthscope Commercial	$4,749.36
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$4,485.51
Rate for Payer: PHP Commercial	$4,485.51
Rate for Payer: Priority Health Cigna Priority Health	$3,693.95
Rate for Payer: Priority Health SBD	$3,324.55

HC PLACE SOFT TISSUE LOCALIZATION DEVICE

Facility

$617.10

Service Code	CPT 10035
Hospital Charge Code	36100486
Hospital Revenue Code	361
Min. Negotiated Rate	$80.88
Max. Negotiated Rate	$1,937.58
Rate for Payer: Aetna Commercial	$524.54
Rate for Payer: Aetna Medicare	$651.08
Rate for Payer: Aetna New Business (MI Preferred)	$401.12
Rate for Payer: Allen County Amish Medical Aid Commercial	$782.55
Rate for Payer: Amish Plain Church Group Commercial	$782.55
Rate for Payer: BCBS Complete	$359.60
Rate for Payer: BCBS MAPPO	$626.04
Rate for Payer: BCBS Trust/PPO	$468.74
Rate for Payer: BCN Medicare Advantage	$626.04
Rate for Payer: Cash Price	$493.68
Rate for Payer: Cash Price	$493.68
Rate for Payer: Cofinity Commercial	$431.97
Rate for Payer: Cofinity Commercial	$530.71
Rate for Payer: Health Alliance Plan Medicare Advantage	$626.04
Rate for Payer: Healthscope Commercial	$555.39
Rate for Payer: Mclaren Medicaid	$342.44
Rate for Payer: Mclaren Medicare	$626.04
Rate for Payer: Meridian Medicaid	$359.60
Rate for Payer: Meridian Wellcare - Medicare Advantage	$657.34
Rate for Payer: MI Amish Medical Board Commercial	$719.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$524.54
Rate for Payer: PACE Medicare	$594.74
Rate for Payer: PACE SWMI	$626.04
Rate for Payer: PHP Commercial	$524.54
Rate for Payer: PHP Medicare Advantage	$626.04
Rate for Payer: Priority Health Choice Medicaid	$342.44
Rate for Payer: Priority Health Cigna Priority Health	$431.97
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$1,937.58
Rate for Payer: Priority Health Medicare	$626.04
Rate for Payer: Priority Health Narrow Network	$1,550.06
Rate for Payer: Priority Health SBD	$388.77
Rate for Payer: Railroad Medicare Medicare	$626.04
Rate for Payer: UHC All Payor (Choice/PPO)	$88.97
Rate for Payer: UHC Core	$1,463.00
Rate for Payer: UHC Dual Complete DSNP	$626.04
Rate for Payer: UHC Exchange	$80.88
Rate for Payer: UHC Medicare Advantage	$644.82
Rate for Payer: VA VA	$626.04

HC PLACE SOFT TISSUE LOCALIZATION DEVICE

Facility

$617.10

Service Code	CPT 10035
Hospital Charge Code	36100486
Hospital Revenue Code	361
Min. Negotiated Rate	$388.77
Max. Negotiated Rate	$555.39
Rate for Payer: Aetna Commercial	$524.54
Rate for Payer: Aetna New Business (MI Preferred)	$401.12
Rate for Payer: Cash Price	$493.68
Rate for Payer: Cofinity Commercial	$530.71
Rate for Payer: Cofinity Commercial	$431.97
Rate for Payer: Healthscope Commercial	$555.39
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$524.54
Rate for Payer: PHP Commercial	$524.54
Rate for Payer: Priority Health Cigna Priority Health	$431.97
Rate for Payer: Priority Health SBD	$388.77

HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION

Facility

$413.27

Service Code	CPT 10036
Hospital Charge Code	36100487
Hospital Revenue Code	361
Min. Negotiated Rate	$260.36
Max. Negotiated Rate	$371.94
Rate for Payer: Aetna Commercial	$351.28
Rate for Payer: Aetna New Business (MI Preferred)	$268.63
Rate for Payer: Cash Price	$330.62
Rate for Payer: Cofinity Commercial	$289.29
Rate for Payer: Cofinity Commercial	$355.41
Rate for Payer: Healthscope Commercial	$371.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$351.28
Rate for Payer: PHP Commercial	$351.28
Rate for Payer: Priority Health Cigna Priority Health	$289.29
Rate for Payer: Priority Health SBD	$260.36

HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION

Facility

$413.27

Service Code	CPT 10036
Hospital Charge Code	36100487
Hospital Revenue Code	361
Min. Negotiated Rate	$40.93
Max. Negotiated Rate	$1,551.38
Rate for Payer: Aetna Commercial	$351.28
Rate for Payer: Aetna New Business (MI Preferred)	$268.63
Rate for Payer: BCBS Complete	$165.31
Rate for Payer: BCBS Trust/PPO	$1,551.38
Rate for Payer: Cash Price	$330.62
Rate for Payer: Cash Price	$330.62
Rate for Payer: Cofinity Commercial	$355.41
Rate for Payer: Cofinity Commercial	$289.29
Rate for Payer: Healthscope Commercial	$371.94
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$351.28
Rate for Payer: PHP Commercial	$351.28
Rate for Payer: Priority Health Cigna Priority Health	$289.29
Rate for Payer: Priority Health SBD	$260.36
Rate for Payer: UHC All Payor (Choice/PPO)	$45.02
Rate for Payer: UHC Core	$878.00
Rate for Payer: UHC Exchange	$40.93

HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS

Facility

$6,494.28

Service Code	CPT 47538
Hospital Charge Code	36100495
Hospital Revenue Code	361
Min. Negotiated Rate	$4,091.40
Max. Negotiated Rate	$5,844.85
Rate for Payer: Aetna Commercial	$5,520.14
Rate for Payer: Aetna New Business (MI Preferred)	$4,221.28
Rate for Payer: Cash Price	$5,195.42
Rate for Payer: Cofinity Commercial	$4,546.00
Rate for Payer: Cofinity Commercial	$5,585.08
Rate for Payer: Healthscope Commercial	$5,844.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,520.14
Rate for Payer: PHP Commercial	$5,520.14
Rate for Payer: Priority Health Cigna Priority Health	$4,546.00
Rate for Payer: Priority Health SBD	$4,091.40

HC PLACE STENT BILE DUCT EA STENT THROUGH EXISTING ACCESS

Facility

$6,494.28

Service Code	CPT 47538
Hospital Charge Code	36100495
Hospital Revenue Code	361
Min. Negotiated Rate	$222.66
Max. Negotiated Rate	$15,754.72
Rate for Payer: Aetna Commercial	$5,520.14
Rate for Payer: Aetna Medicare	$5,339.45
Rate for Payer: Aetna New Business (MI Preferred)	$4,221.28
Rate for Payer: Allen County Amish Medical Aid Commercial	$6,417.61
Rate for Payer: Amish Plain Church Group Commercial	$6,417.61
Rate for Payer: BCBS Complete	$2,949.02
Rate for Payer: BCBS MAPPO	$5,134.09
Rate for Payer: BCBS Trust/PPO	$3,818.41
Rate for Payer: BCN Medicare Advantage	$5,134.09
Rate for Payer: Cash Price	$5,195.42
Rate for Payer: Cash Price	$5,195.42
Rate for Payer: Cofinity Commercial	$5,585.08
Rate for Payer: Cofinity Commercial	$4,546.00
Rate for Payer: Health Alliance Plan Medicare Advantage	$5,134.09
Rate for Payer: Healthscope Commercial	$5,844.85
Rate for Payer: Mclaren Medicaid	$2,808.35
Rate for Payer: Mclaren Medicare	$5,134.09
Rate for Payer: Meridian Medicaid	$2,949.02
Rate for Payer: Meridian Wellcare - Medicare Advantage	$5,390.79
Rate for Payer: MI Amish Medical Board Commercial	$5,904.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,520.14
Rate for Payer: PACE Medicare	$4,877.39
Rate for Payer: PACE SWMI	$5,134.09
Rate for Payer: PHP Commercial	$5,520.14
Rate for Payer: PHP Medicare Advantage	$5,134.09
Rate for Payer: Priority Health Choice Medicaid	$2,808.35
Rate for Payer: Priority Health Cigna Priority Health	$4,546.00
Rate for Payer: Priority Health HMO/PPO/Tiered Network	$15,754.72
Rate for Payer: Priority Health Medicare	$5,134.09
Rate for Payer: Priority Health Narrow Network	$12,603.78
Rate for Payer: Priority Health SBD	$4,091.40
Rate for Payer: Railroad Medicare Medicare	$5,134.09
Rate for Payer: UHC All Payor (Choice/PPO)	$244.93
Rate for Payer: UHC Core	$7,632.00
Rate for Payer: UHC Dual Complete DSNP	$5,134.09
Rate for Payer: UHC Exchange	$222.66
Rate for Payer: UHC Medicare Advantage	$5,288.11
Rate for Payer: VA VA	$5,134.09

HCPLACE STENT BILE DUCT EA STENT THROUGH NEW ACCESS

Facility

$6,494.28

Service Code	CPT 47539
Hospital Charge Code	36100496
Hospital Revenue Code	361
Min. Negotiated Rate	$4,091.40
Max. Negotiated Rate	$5,844.85
Rate for Payer: Aetna Commercial	$5,520.14
Rate for Payer: Aetna New Business (MI Preferred)	$4,221.28
Rate for Payer: Cash Price	$5,195.42
Rate for Payer: Cofinity Commercial	$4,546.00
Rate for Payer: Cofinity Commercial	$5,585.08
Rate for Payer: Healthscope Commercial	$5,844.85
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS	$5,520.14
Rate for Payer: PHP Commercial	$5,520.14
Rate for Payer: Priority Health Cigna Priority Health	$4,546.00
Rate for Payer: Priority Health SBD	$4,091.40

Know your out-of-pocket cost for care.

All Charges